Aims-To follow visual acuity (VA) and progression of diabetic retinopathy (DR) after phacoemulsification in diabetic patients with diVerent stages of DR and controls. Methods-This

Extracapsular cataract extraction followed by implantation of a one-piece posterior chamber polymethylmethacrylate intraocular lens (IOL) into the capsular bag was performed in 25 eyes with exfoliation syndrome and 20 control eyes. The patients were investigated preoperatively and then 1 day, 1 week, 3, 6 and 12 months after surgery. Preoperatively, maximal pupil dilatation was significantly smaller in eyes with exfoliation syndrome compared to controls. During surgery the incidence of complications such as ruptures of the zonule or posterior lens capsule, were higher in eyes with exfoliation syndrome. Furthermore, postoperative complications, such as fibrinoid reaction anterior to the IOL followed by posterior synechias and cell deposits, were more common in eyes with exfoliation syndrome compared to control eyes. The results imply that compared to control eyes, eyes with exfoliation syndrome are likely to present more complications both during extracapsular cataract extraction with implantation of intraocular lenses and postoperatively.

In spite of good anatomical and functional results, this study showed higher rate of endophthalmitis than the latest reports suggesting that small-gauge vitrectomy has reached the safety level of standard 20-gauge vitrectomy when infectious endophthalmitis is concerned.

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